Contract Management System Analyst

Dartmouth-Hitchcock Health•Lebanon, NH

About The Position

Supports the D-H Payment Innovation - Contracting goals of ongoing revenue cycle and contract improvement through development and maintenance of an effective system-wide program for managing third-party payor contractual reimbursement terms within a proprietary free-standing Contract Management System (CMS) for D-H and other D-HH affiliate members who have chosen to implement the CMS. Responsibilities Works collaboratively with D-H departments, including D-HH affiliate members, to maximize revenue opportunities in a compliant manner. Utilizes a comprehensive understanding of third-party payor reimbursement methodologies and contract terms to model contract rate proposals, monitor contract performance, report on reimbursement trends, and conduct other financial analysis as necessary. Identify issues pertaining to accuracy of the expected payment calculations and data integrity with the CMS. Assumes responsibility for supporting contract negotiations through development of contract modeling and contract performance reporting using multiple CMS, EPIC, WEBI, and other analytical tools and databases as necessary. Conducts ad hoc data requests. Assists the contract negotiation team in reviewing and analyzing contract proposals and provides input as to the ease of administration of proposed terms and conditions. Uses CMS to research and investigate any issues with contract implementation or on-going contract performance and develop reports to outline issue and proposed solution for discussion with Director of Contracting or other members of the contract negotiation team. Manages and maintains key financial benchmarking activities and provides quarterly benchmark reports to senior leadership and the Contract Steering Committee. Demonstrates strong financial and analytical skills and problem-solving skills involving the use of multiple systems and decision support databases. Serves as the Contracting representative for work groups as assigned to facilitate communication and data integrity within DH. Keeps Contracting department informed of activities and issues related to contract and financial performance. Works with CMS vendors to provide program analysis and assist in the development of CMS product enhancements and improvements to create more effective and efficient systems. Participates in user group conferences and focus groups. Develops and maintains the highest quality of system performance for the CMS products. Educates, trains, and mentors individual CMS team members in the use of the CMS system as well as interpretation of contract terms and conditions and hospital and physician reimbursement rules to ensure that reports and requests for revenue recoupments to third-party payors are as accurate and complete as possible. Performs other duties as required or assigned.

Requirements

Bachelor’s degree with an emphasis on finance and/or information systems with 5 years of experience, or the equivalent in education and/or experience required.
Experience in a multi-vendor environment and knowledge of database applications required.
Strong aptitude for mathematics is essential.
Excellent interpersonal skills required.
Must also be comfortable working with commercial payors and co-workers at all levels within the DH organization.
Proven ability to manage multiple projects and competing deadlines while working independently with little supervision desired.
Must possess the ability to be organized in a fast-paced environment and be able to act in a consulting capacity.

Nice To Haves

Experience in an academic medical center setting preferred.
Knowledge of analytical software desired.

Responsibilities

Works collaboratively with D-H departments, including D-HH affiliate members, to maximize revenue opportunities in a compliant manner.
Utilizes a comprehensive understanding of third-party payor reimbursement methodologies and contract terms to model contract rate proposals, monitor contract performance, report on reimbursement trends, and conduct other financial analysis as necessary.
Identify issues pertaining to accuracy of the expected payment calculations and data integrity with the CMS.
Assumes responsibility for supporting contract negotiations through development of contract modeling and contract performance reporting using multiple CMS, EPIC, WEBI, and other analytical tools and databases as necessary. Conducts ad hoc data requests.
Assists the contract negotiation team in reviewing and analyzing contract proposals and provides input as to the ease of administration of proposed terms and conditions. Uses CMS to research and investigate any issues with contract implementation or on-going contract performance and develop reports to outline issue and proposed solution for discussion with Director of Contracting or other members of the contract negotiation team.
Manages and maintains key financial benchmarking activities and provides quarterly benchmark reports to senior leadership and the Contract Steering Committee.
Demonstrates strong financial and analytical skills and problem-solving skills involving the use of multiple systems and decision support databases.
Serves as the Contracting representative for work groups as assigned to facilitate communication and data integrity within DH. Keeps Contracting department informed of activities and issues related to contract and financial performance.
Works with CMS vendors to provide program analysis and assist in the development of CMS product enhancements and improvements to create more effective and efficient systems. Participates in user group conferences and focus groups.
Develops and maintains the highest quality of system performance for the CMS products.
Educates, trains, and mentors individual CMS team members in the use of the CMS system as well as interpretation of contract terms and conditions and hospital and physician reimbursement rules to ensure that reports and requests for revenue recoupments to third-party payors are as accurate and complete as possible.
Performs other duties as required or assigned.